| NPI | 1326552282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 43-557576-122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 252662) |
| 163W00000X Registered Nurse (Licence: KS 14-142778-122) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: KS 155909) | |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2018-05-11 |